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Sachiyo Nakamura, Akihiro Shuda
Article type: Review
2025Volume 45 Pages
1-13
Published: 2025
Released on J-STAGE: April 23, 2025
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Aim: The aim of this study was to clarify the structure of “Work Attitudes Affecting Nurses’ Health” and to examine the concept’s applicability.
Methods: The study utilized Rodgers & Knafl’s (2000) concept analysis approach, analyzing 46 references from four databases.
Results: The analysis identified six attributes of work attitudes affecting nurses’ health:, low opinion of oneself, feeling confused about how to be as a nurse, self-deception about one’s true feelings, feeling the pressure of the role, prioritizing others at one’s own expense, and losing oneself in one’s work. Five antecedents and three consequences were identified.
Conclusions: Work attitudes that affect nurses’ health were defined as a state in which nurses are positive, putting patients before themselves out of a sense of responsibility and devoting themselves to their work, but are at risk of choosing a way of working that could affect their own health due to confusion about how to be a nurse, combined with pressure to work due to a low self-esteem. This concept highlights the importance of self-awareness in balancing work and health and is recommended for inclusion in basic nursing education to help students manage their health and foster psychological safety within organizations.
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Hiroko Arai, Yoko Tokiwa
Article type: Review
2025Volume 45 Pages
49-59
Published: 2025
Released on J-STAGE: May 20, 2025
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Objective: The purpose of this study was to clarify the concept of meaning-making, examine its characteristics, and explore its applicability to psychological care.
Methods: A conceptual analysis of 30 domestic and international publications was performed using Rodgers’ method.
Results: The attributes identified include “confrontation with the self,” “transformation of thinking,” “discovery of a new self,” and “new interpretations.” Six categories of antecedents and three categories of consequences were derived.
Conclusion: The concept of meaning-making was defined as “the process of confronting oneself in challenging situations, transforming one’s way of thinking, discovering a new self, and reinterpreting oneself.” This cognitive approach aimed at overcoming difficulties was shown to play a crucial role in promoting personal growth and adaptation. The study also suggested the possibility of applying the concept of meaning making to psychological care.
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Saeko Ando, Kimiko Iwase, Hitomi Katsuda
Article type: Review
2025Volume 45 Pages
200-213
Published: 2025
Released on J-STAGE: June 27, 2025
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Objective: To review the literature on employment and psychiatric comorbidities in adults with childhood-onset epilepsy and to investigate study trends and challenges in transition support.
Methods: Databases utilized included PubMed, CINAHL, and Ichushi WEB. The inclusion criteria for literature selection required that the subjects be patients with childhood-onset epilepsy and that the literature describe psychiatric symptoms and employment.
Results: A total of 27 pieces of literature were analyzed. Four studies indicated a significant association between psychiatric symptom comorbidity and employment, whereas four studies reported no association, presenting contradictory results across the literature. Furthermore, patients’ quality of life was correlated with the presence of psychiatric symptoms, employment status, seizure frequency, and side effects of antiepileptic drugs. Intervention research indicates that group sessions and telephone contact with nurses are effective in alleviating psychiatric symptoms.
Conclusion: There is a need for qualitative research on negative experiences at work and on readiness to cope with stress and self-management during the transition period.
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Jongmi Seo, Tomoko Sugimoto
Article type: Review
2025Volume 45 Pages
214-226
Published: 2025
Released on J-STAGE: June 27, 2025
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Aim: The aim of this study was to clarify the attributes, antecedents and consequences of the concept, dementia-related caregiver burden.
Method: Based on a Rodgers’ concept analysis approach (Rodgers & Knafl, 2000), 54 articles until 2023 were fully reviewed in both Japanese and English.
Results: The four attributes were extracted: negative feelings to care recipients, exhaustion from dealing with BPSD, anxiety about difficult dementia care, moral distress. Also, four antecedents and three consequences were identified.
Conclusions: The burden on formal caregivers for residents with dementia was defined as a circumstance where formal caregivers have negative feelings, feel exhausted from dealing with BPSD, feel anxious about difficult dementia care and have moral distress. In order to ensure the quality of dementia care and secure human resources, it is important to alleviate the dementia-related caregiver burden on care practitioners.
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Hoshina Uehara, Mayuko Yamashita
Article type: Review
2025Volume 45 Pages
306-318
Published: 2025
Released on J-STAGE: July 23, 2025
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Objective: This study aimed to obtain a definition of clinical judgment in spiritual care.
Methods: Six databases were searched: Ichushi-Web, CiNii, PubMed, CINAHL, Academic Search, and ScienceDirect. Search terms included “clinical judgment” and “spiritual care.” Meeting the criteria were 36, which were analyzed using Rodgers’ evolutionary method of concept analysis.
Results: The following four attributes were extracted: “gaining clues about the patient’s spirituality through everyday observations,” “Seeing the patient as a whole person and thinking deeply about even the inner world of a patient,” “deciding the timing of care while considering the time limit,” and “deciding the direction of care for healing or self-exploration.”
Conclusion: This concept of clinical judgment in spiritual care is defined as follows: identifying clues related to the patient’s spirituality through daily observations, while being mindful of limited time, and understanding the patient’s inner world holistically, in order to determine the direction of care for healing or self-exploration.
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Yukie Kameda, Sumire Koma, Miwa Imai, Mika Kawai
Article type: Review
2025Volume 45 Pages
373-383
Published: 2025
Released on J-STAGE: August 01, 2025
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Objective: We conducted a scoping review to identify effective interventions delivered to mothers to promote cervical cancer prevention behaviors among young women in Japan and to explore research gaps in the literature.
Methods: The electronic databases PubMed, CINAHL and Ichushi Web were searched for original articles published in English and Japanese between June 2006 and August 4, 2024, describing cervical cancer prevention interventions delivered to mothers. Fourteen original research papers were analyzed.
Results: Effective intervention methods were identified that enhanced mothers’ intensions of cervical cancer prevention in their daughters. These included the distribution of media content recommending vaccination against human papillomavirus and incorporating kinship caregiving messages that encourage actions to protect children’s health and future, combined with educational information; narrative messages from mothers whose daughters have experienced cervical cancer; the distribution of information leaflets combined with information provided by physicians in face-to-face settings; and the mailing of individual vaccination invitation notifications and educational materials from local government. Future studies are needed to develop an effective media strategy to deliver educational materials, conduct long-term evaluations of intervention effects, and identify effective intervention strategies to promote cervical cancer screening targeted at mothers with daughters of approximately 20 years of age.
Conclusion: Effective interventions to promote cervical cancer prevention behaviors targeted at mothers were identified. These findings provide valuable insights for planning cervical cancer awareness and education programs.
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Tomoko Umemoto, Mayu Sakamoto, Namiko Kawamura
Article type: Original Article
2025Volume 45 Pages
14-24
Published: 2025
Released on J-STAGE: April 23, 2025
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Objective: The aim was to elucidate the pathways and experiences of novice nurses who choose to continue working despite experiencing communication difficulties in the workplace.
Methods: Semi-structured interviews were conducted with five novice nurses. Themes were extracted using phenomenological methods and were subsequently used to model the process through Trajectory Equifinality Modeling.
Results: From the interviews, four thematic stages were identified: (1) Frustration and distress from being unable to demonstrate one’s worth to senior nurses, (2) Putting on a brave front, (3) Struggling to find one’s ideal nursing practice despite inadequate job performance, and (4) Achieving growth as a ‘nurse’.
Conclusion: Novice nurses experience communication difficulties with senior members of staff and through incidents and interactions with their peers, recognize their own growth, interpersonal relationships, and support from their environment. This recognition leads to a renewed motivation for growth and the choice to continue in their profession. This process can be considered as the emergence of ‘self-transformation’.
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Naohiro Maeda, Hitoshi Fujii, Minoru Itayama
Article type: Original Article
2025Volume 45 Pages
25-38
Published: 2025
Released on J-STAGE: April 30, 2025
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Objective: This study aimed to clarify the actual conditions of the frequency of self-management (SM) education, nursing issues, frequency of collaboration with other professionals, difficulties faced by home-visit nurses for patients with chronic obstructive pulmonary disease (COPD), and the relationship between these experiences and home-visit nurses’ clinical experiences.
Methods: A postal questionnaire survey was conducted with 3,000 home-visit nurses nationwide. After calculating the basic statistics, the differences between the frequency of SM education, nursing issues, frequency of collaboration with other professions, and clinical experiences were analyzed using the Mann–Whitney U test. The free-description categories of difficulty were extracted using content analysis.
Results: The analysis included 305 participants. Regarding the frequency of SM education, instruction on the assessment of shortness of breath was the least common and significantly less common in the group with no experience in respiratory wards. Additionally, the group with no experience in respiratory wards was more likely to experience difficulties in home-visit nursing for patients with COPD.
Conclusion: To promote SM education among home-visit nurses, there is a need to disseminate expertise and reduce feelings of difficulties.
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Kiyoko Kimura, Yuki Morooka
Article type: Original Article
2025Volume 45 Pages
39-48
Published: 2025
Released on J-STAGE: May 14, 2025
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Objective: This study aims to identify issues in the health-seeking behaviour of international students in Japan as perceived by teaching staff at Japanese language schools.
Methods: We conducted semi-structured interviews with 10 teachers and staff from Japanese language schools. The data obtained were analysed using qualitative descriptive methods.
Results: “Disadvantage in receiving medical examinations due to being an international student in Japan”, “Due to the limitations of Japanese language skills, conversations during medical examinations do not convey the true meaning”, “They have to rely on teachers to make decisions, including whether they need to see a doctor.” It was shown to be the case. In addition, “Due to differences in social systems and customs from their home country, they are not familiar with typical healthcare-seeking behaviors in Japan.” This they faced. “Health-seeking behaviours are burdensome due to residency in situations where economic resources are not available.” This has been shown to be the case.
Conclusion: It has been suggested that, in order for international students living in Japan to make use of medical institutions, it is necessary not only to improve the systems on the part of the medical institutions but also to provide information to the students and Japanese language schools, and to establish support systems by medical professionals.
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Hiroshi Ono, Rika Watanabe, Eiko Nakanishi, Takanori Kawano, Kenji Awa ...
Article type: Original Article
2025Volume 45 Pages
60-71
Published: 2025
Released on J-STAGE: May 20, 2025
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Purpose: Small-scale multifunctional in-home nursing care, called Kantaki, is a new service that combines day care, home-visit nursing, and short-stay services. This study developed a self-assessment scale for practical nursing skills required by nurses engaged in Kantaki and examined its validity.
Methods: Using the developed assessment instrument, a questionnaire survey was conducted with registered nurses from 729 Kantaki facilities that were open by the end of June 2021. The scale’s factor structure was determined, and the internal consistency, content validity, construct validity, and criterion validity were evaluated.
Results: From the 949 distributed questionnaires, 865 responses were received. Of these, 649 questionnaires with responses to all items were analyzed. Subsequently, a scale comprising 59 items and nine factors was developed. Cronbach’s alpha coefficient was greater than 0.9 for each factor. Content and construct validities were sufficient, and the factor points of each factor for participants with more than three years of clinical experience were significantly higher than for those with less than three years of clinical experience.
Conclusion: The developed scale had adequate validity, and can be used to evaluate care provided by nurses in Kantaki.
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Chizuko Oga, Tomomi Azuma
Article type: Original Article
2025Volume 45 Pages
72-80
Published: 2025
Released on J-STAGE: May 20, 2025
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Objective: To find an association between career plateau measurement scale scores and the intention to continue working in the current position among mid-career nurses.
Methods: A total of 528 mid-career nurses underwent a survey on the intention to continue working in the current position and career plateau. The career plateau measurement scale for mid-career nurses was used to measure career plateau. The cutoff score of the scale for the intention to continue was calculated through receiver operating characteristic analysis and used to divide the nurses into “plateau group” and “non-plateau group.” Then, a binomial logistic regression analysis was conducted using the intention to continue working in the current position as a dependent variable and the presence or absence of a plateau or scale score and potential confounding factors as explanatory variables.
Results: The career plateau was significantly associated with the intention to continue working in the current position (adjusted odds ratio 2.70, 95% confidence interval [CI] 1.83–3.98, p < 0.001). The scale scores were also significantly associated with the intention to continue working in the current position (adjusted odds ratio 0.97, 95% CI 0.95–0.98, p < 0.001).
Conclusion: The career plateau measurement scale score for mid-career nurses may be a useful measure associated with the intention to continue working in the current position.
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Hirohito Nanbu, Fumiya Tanji, Maiko Kawajiri, Daisaku Nishimoto
Article type: Original Article
2025Volume 45 Pages
99-109
Published: 2025
Released on J-STAGE: June 09, 2025
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Objective: This study aims to identify factors influencing healthcare-seeking behavior for late-onset hypogonadism (LOH), focusing on age, awareness, and AMS score.
Methods: A web-based survey was conducted with 1,500 men aged 20 to 69 across Japan, gathering open-ended responses on factors that encourage health-seeking behaviors for LOH symptoms. A total of 1,168 responses were analyzed using text mining with KH Coder.
Results: Based on 2,091 extracted words, four categories emerged: (1) conditions and support that promote health-seeking behaviors, (2) economic and social barriers to seeking care, (3) psychological and knowledge-related barriers, and (4) limitations in the healthcare system and institutional structure.
Conclusion: Support from the workplace and family, enhancement of financial assistance, and the development of specialized healthcare systems are essential for promoting healthcare-seeking behavior.
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Kumi Yoshiba, Nobuaki Morita
Article type: Original Article
2025Volume 45 Pages
110-120
Published: 2025
Released on J-STAGE: June 09, 2025
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Aim: This study aims to elucidate the help-seeking process of mothers experiencing parenting difficulties with their infant children.
Methods: Semi-structured interviews were conducted with 26 mothers who have experienced parenting difficulties with their infant children. The data were analyzed using the Modified Grounded Theory Approach for qualitative research.
Results: Mothers experiencing [perceived sense of parenting difficulties] [seek help] to resolve their difficulties and [explore optimal parenting methods]. They [select methods] based on [relationships that facilitate help-seeking] in daily life, and «seek relief», which ultimately leads to [obtaining reassurance]. Mothers who feel [resistant to help-seeking] and have [a sense of giving up on help-seeking] in face-to-face contexts often opt for [online help-seeking], which also helps them [obtain reassurance].
Conclusion: This study identified the help-seeking process of mothers experiencing parenting difficulties with their infant children. It is essential for nursing professionals to promote awareness of this process and incorporate this understanding into their nursing practice.
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Sachie Okanishi, Sawa Fujita
Article type: Original Article
2025Volume 45 Pages
121-131
Published: 2025
Released on J-STAGE: June 16, 2025
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Purpose: The purpose of this study was to elucidate the process of harmony in the lives of recurrent and metastatic cancer survivors during recuperation.
Methods: Semi-structured interviews were conducted on 16 participants, and the data were analyzed using the Modified Grounded Theory Approach (M-GTA).
Results: The process of harmony in the lives of recurrent and metastatic cancer survivors during recuperation centered on “Living with a neutral self”, in which there was an expansive process of self-awareness from [Wavering self-existence in changing circumstances] to [Putting death aside and remaining true to oneself], [Cancer is a part of me], and [Perceiving expansion of the self]. This was supported and facilitated by the interactions of strategies for [Directing one’s attention to what one has at the moment] and [Maintaining a stable self]. “Living with a neutral self” is a state in which the individual maintains an unwavering self amid the constant changes that occur during the process of repeated rounds of recurrence and metastasis of cancer, and was strengthened by cycling through this process.
Conclusion: These results suggest that promotion of the recovery and the expansion of self-awareness and sense of control that centers on “Living with a neutral self” serve as support for survivors’ recuperation in maintaining the best possible health.
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Yoko Matsuzaki, Kazuko Horiguchi, Noboru Iwata
Article type: Original Article
2025Volume 45 Pages
132-141
Published: 2025
Released on J-STAGE: June 16, 2025
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Objective: To identify the state of self-neglect among elderly and classify.
Methods: A self-administered questionnaire survey was conducted among professionals with experience in dealing with self-neglect cases at comprehensive community support centers and social welfare councils in six Kinki prefectures. Responses were obtained for 151 self-neglect cases.
Results: A principal component analysis was conducted on responses to 34 items describing self-neglect conditions and behaviors. Five components were extracted: unsanitary living environment, inappropriate healthcare behaviors, unhygienic housing environment, poor money management, and poor interpersonal relationships. A cluster analysis using these components revealed four self-neglect types: poor interpersonal relationships (34%), money management difficulties (26%), overall low group (23%) and poor living environment group (14%). There were differences between the clusters in the degree of independence in daily living of the disabled elderly and the elderly with dementia, the type and severity of self-neglect, and the older people’s own acceptance of others.
Conclusion: The self-neglect status of older people can be typified into four groups, and the characteristics between the clusters of typologies suggest the need for interventions and support accordingly.
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Ayumi Ogura, Yuko Hiratani, Tomoyuki Kawamura
Article type: Original Article
2025Volume 45 Pages
142-151
Published: 2025
Released on J-STAGE: June 20, 2025
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Objectives: This study aimed to clarify parental involvement in the transition to self-care for school-aged children with type 1 diabetes.
Methods: We conducted semistructured interviews with 10 parents of children of school age or older, who were diagnosed with type 1 diabetes before the age of 9 years. The interview data were analyzed using qualitative inductive methods.
Results: All study participants were mothers, and all children were using continuous subcutaneous insulin infusion. Based on the analysis, six categories were extracted: “Complementing diabetes management that is difficult for the child to manage by themself,” “Managing diabetes with the child,” “Gradually promoting the child’s self-management of diabetes under parental supervision,” “Collaborating with school staff to manage diabetes in school,” “Establishing a safe and secure environment for children,” and “Devising ways to encourage the child’s independence”.
Conclusion: Parental involvement in the transition to self-care helps children will take the intiative in managing diabetes and live with type 1 diabetes.
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Tatsuhito Kamimoto, Sumie Ikezaki
Article type: Original Article
2025Volume 45 Pages
152-163
Published: 2025
Released on J-STAGE: June 20, 2025
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Objective: This study aimed to develop a scale for measuring the leadership behaviors of visiting nurse managers.
Methods: A nationwide survey was conducted using internet-based or mailed questionnaires targeting 3,000 visiting nurses across Japan. The survey included a 39-item scale designed to evaluate managers’ leadership behavior from the perspectives of their subordinates. The reliability and validity of the scale were also assessed.
Results: In total, 577 responses were received (response rate: 19.3%). Exploratory factor analysis identified 16 items organized into two factors. The model fit indices were as follows: GFI = .936, AGFI = .909, CFI = .973, and RMSEA = .062. Correlation coefficients with external criteria ranged from r = .768 to .818. Cronbach’s alpha for the complete scale was .959, and the test-retest correlation coefficient was r = .716.
Conclusions: The scale demonstrated strong reliability and validity, as well as favorable model fit indices. This suggests that it is a robust tool for evaluating visiting nurse managers’ leadership behavior.
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Mikiko Arita, Mayumi Kato
Article type: Original Article
2025Volume 45 Pages
164-177
Published: 2025
Released on J-STAGE: June 27, 2025
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Objective: The purpose of this study was to clarify the perceptions of clinical practice instructors and university faculty regarding responsible behavior of nursing trainees.
Methods: Data was collected using semi-structured interviews with 21 instructors and 22 faculty members, and a mixed methods of quantitative analysis using text mining and qualitative inductive analysis was used.
Results: The agreement rate of the main words in both was 85.3% and the Kappa coefficient was 0.71. As a responsible behavior, trainees take “Behavior to face their own anxiety” before the practice; and during the practice, while development of “Behavior of learning how to learn to improve practical skills,” “Learning behavior reflecting on nursing practice,” “Behavior showing interest in the other person’s state,” “Behavior considering the other’s point of view,” “Behavior that understands and conveys meaning,” “Obeying rules while thinking about reasons,” “Behavior that control safety,” “A practical attitude that builds trust,” and “Behavior that evaluates one’s own efforts,” was required.
Conclusion: Both considered responsible behaviors to be taken by the trainees to learn, as well as behaviors that are controlled with consideration for the client’s safety and relationship building.
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Satomi Arai, Yukari Nakada, Hayato Higa
Article type: Original Article
2025Volume 45 Pages
178-188
Published: 2025
Released on J-STAGE: June 27, 2025
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Purpose: This study aims to clarify the process of how clinical nurses’ recuperation support promotes behavior change in hospitalized patients with predialysis chronic kidney disease.
Methods: Semi-structured interviews were conducted with ten clinical nurses who provided kidney disease guidance to hospitalized patients, and the results were analyzed using the Modified Grounded Theory Approach (M-GTA).
Results: In recuperation support, the clinical nurse works with the patient to find recuperation behaviors in which the patient is willing to engage. In this process, the nurse begins by “perceiving the patient’s recuperation experiences and wishes.” This leads to the nurse “getting approved by the patient,” “taking time to confirm the patient’s words (thoughts) and explain things to the patient,” and “building rapport and working with the patient to find suitable recuperation behaviors for the patient,” which promote the patient’s behavior change. When the nurse listens to the patient’s story, actions that may suppress behavior change, such as the nurse “being hesitant” and “giving one-sided guidance,” are still observed. However, continuous recuperation support that promotes behavior change can be accomplished by “supporting the patient as a team.”
Conclusion: This study suggests that “getting approved by the patient” by “perceiving the patient’s recuperation experiences and wishes” is important in helping the nurse provide recuperation support that promotes behavior change in hospitalized patients with chronic kidney disease.
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Saori Fukuda, Akiko Hiyama, Masumi Muramatsu, Atsuko Hinotsu
Article type: Original Article
2025Volume 45 Pages
236-245
Published: 2025
Released on J-STAGE: July 09, 2025
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Objective: To clarify nursing practices with a focus on life after discharge in preoperative outpatient care.
Methods: Semi-structured individual interviews were conducted with nurses providing preoperative outpatient care. The interview content was then analyzed using the Klaus Krippendorff’s method. The verbatim transcripts for each participant were carefully read. The narratives of nursing practices in preoperative outpatient care were extracted in the participants own words, written down to clarify the content, and then coded. The codes for all participants were categorized and subcategorized into common items while the similarities and differences in meaning were examined.
Results: Six nurses were included with a mean interview time of 43 min. Through content analysis, nursing practices in preoperative outpatient care with a view of life after discharge were represented by 235 codes, 53 subcategories, and 9 categories.
Conclusion: Support for physical readiness for safe perioperative management was provided in collaboration with other nurses and multidisciplinary staff. Additionally, nurses focused on understanding the patient’s thoughts, values, and living situation according to mental and social information, and provided support for decision-making and living with postoperative changes.
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Kazuyo Suzuki
Article type: Original Article
2025Volume 45 Pages
246-257
Published: 2025
Released on J-STAGE: July 11, 2025
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Purpose: To examine the feasibility of nursing intervention to reorganize movements in patients in the acute phase immediately after the onset of stroke. Specifically, the purpose of this study is to clarify the sample size and the validity of the indices necessary to verify the effectiveness of the intervention, as well as the issues to be addressed in order to conduct a full-scale study.
Methods: This study included 40 patients (control group, n = 20; intervention group, n = 20) 60–85 years old who were admitted to the Stroke care unit within 3 days after the onset of stroke. Nursing intervention to reorganize movements was performed from days 4 to 15 after the onset of stroke, and the effectiveness of the intervention was analyzed using the Functional Independence Measure (FIM).
Results: There was no statistically significant difference in the outcome measures between the control and intervention groups. In an analysis limited to patients with NIHSS <20 on admission, the intervention group had a higher FIM cognitive score improvement on day 15, which was a statistically significant difference.
Conclusion: The results of this study revealed the issues associated with conducting a full-scale study in the future, such as establishing the necessary sample size, the need to standardize the assessment instruments, the methodology, and the other research methods.
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Mitsuko Yoshida, Yoshihito Toyama, Chie Taniguchi, Satomi Kita
Article type: Original Article
2025Volume 45 Pages
258-266
Published: 2025
Released on J-STAGE: July 14, 2025
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Purpose: The purpose of this study was to find out what women diagnosed with cancer during pregnancy experienced in their cancer treatment and childcare.
Methods: Narrative analysis was conducted in March-July, 2023 after interviewing two women who had been diagnosed with cancer during pregnancy.
Results: The following themes (in quotation marks) were identified. Ms. A underwent anticancer drug therapy during her pregnancy for breast cancer and “kept being worried about her fetus, feeling anxiety, sense of being alienated and loneliness.” After giving birth, she “struggled every day and barely managed to take care of her baby while continuing hospital visits for cancer treatment.” After several years, she “is happily enjoying ordinary daily life, which she appreciates.” Ms. B underwent surgery during her pregnancy for a soft tissue tumor. She “felt anxious, alienated, and lonely, and was more worried about whether she would be able to give birth to her baby than about her own cancer.” She did not feel well after giving birth and she “could only manage daily care of her baby, neglecting her own body as secondary importance,” but gradually began to “pay attention to her own life while cherishing time with her baby.”
Conclusion: It is extremely difficult to assume the role of mother, including breast feeding and childcare, while at the same time being an outpatient with poor physical and mental condition due to cancer treatment. A support system needs to be established for such women and their families.
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Sho Nagai, Emiko Shinozaki
Article type: Original Article
2025Volume 45 Pages
267-277
Published: 2025
Released on J-STAGE: July 15, 2025
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Objective: This study aimed to explore how adults with mental illness who experienced child maltreatment from caregivers in childhood narrate and reinterpret their life stories.
Methods: Guided by a dialogic constructionist approach, we conducted a life story study with three female participants. Each participant underwent three sessions of non-structured, in-depth interviews, which were audio-recorded and transcribed verbatim. Data analysis proceeded in two phases: (1) examining “tale worlds” to identify narrative content and themes, and (2) focusing on “story realms” to investigate how interviewer–interviewee interactions shaped the storytelling process. The research received ethical approval from the university’s Ethics Committee (Approval No. 2023N-024), and informed consent was obtained from all participants.
Results: Although participants described various traumatic childhood experiences and ongoing struggles with mental illness, they also identified subtle positive elements that contributed to their current sense of self and relationships. These findings revealed a complex interplay between negative past events and newly discovered meanings, indicating potential pathways for resilience and growth.
Conclusion: The study highlights the value of narrative-based support that respects the multifaceted contexts of survivors rather than focusing solely on pathology. Recognizing both adversity and positive aspects within their life stories may enhance clinical and community interventions for individuals seeking to make sense of their past experiences and move toward recovery.
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Miho Watanabe, Rika Shiomi, Kumiko Takezaki
Article type: Original Article
2025Volume 45 Pages
286-294
Published: 2025
Released on J-STAGE: July 17, 2025
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Aim: The purpose of this study is to elucidate the care innovations practiced by advanced practice nurses (geriatric nurses and certified dementia nurses) on elderly dementia patients during the postoperative bed rest period to provide optimal rest for both patients and nurses.
Method: Semi-structured interviews were conducted with six advanced practice nurses working in acute care hospitals, and a qualitative content analysis was carried out.
Results: The analysis also clarified the three categories [early response to signs that may lead to agitation or confusion], [reduction of pain associated with bed rest], and [innovations for postoperative management that do not rely on physical limitations] to achieve these categories. These innovations not only reduced the discomfort and pain caused by postoperative bed rest, delirium, and confusion in elderly dementia patients, but also reduced care difficulties for nurses.
Conclusion: Nursing practices that address the discomfort associated with bed rest, determine the appropriate timing for medication, ensure pain relief and adequate sleep on the surgery day, and focus on removing physical restraints can provide comfort to both patients and nurses.
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Shoko Atsumi, Masako Aoki
Article type: Original Article
2025Volume 45 Pages
295-305
Published: 2025
Released on J-STAGE: July 23, 2025
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Objective: This study aimed to clarify the process of caregiver-supplemented self-care needed for children with atopic dermatitis during late infancy.
Method: Semi-structured interviews were conducted with 16 mothers of children who were aged 3–11 years and diagnosed with atopic dermatitis in infancy. Data were analyzed using the grounded theory approach.
Results: Mothers continued to “dialogue with the child as he/she is,” and repeated “strategies to ensure care becomes part of the child’s daily life,” “daring to create a void” and “readjustment of the complement,” which led to the development of their children’s self-care skills by adjusting the complementary care.
Conclusion: Expanding a child’s self-care abilities in late infancy is challenging and requires sustained support for mothers to integrate care into child’s daily life, adopt the perspective of “creating a daring void” to adjust retention and release of care while considering atopic dermatitis symptoms. Support that can expand both child’s self-care and the mother’s ability to provide effective care is essential.
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Mariko Oshiro, Midori Kamizato, Tomoharu Genka, Sayuri Jahana
Article type: Original Article
2025Volume 45 Pages
327-337
Published: 2025
Released on J-STAGE: July 25, 2025
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Objective: To clarify the difficulties breast cancer patients living on remote islands perceived when visiting specialized breast cancer medical institutions outside the island for treatment and subsequent follow-up care.
Method: Semi-structured interviews were conducted with 14 breast cancer patients living on remote islands, and qualitative descriptive analysis was conducted.
Results: Breast cancer patients living on remote islands held physical, mental, and financial difficulties associated with the procedures and arrangements required to travel outside the island to visit specialized breast cancer medical institutions outside the island. In addition, difficulty in obtaining support from family and medical professionals during treatment was also identified as a difficulty. Breast cancer requires long-term treatment and follow-up, and difficulties were identified in traveling outside the island for long periods of time.
Conclusion: Breast cancer patients living on remote islands felt difficulties unique to remote islands when accessing specialized cancer medical institutions outside the island. In the future, continuous support system will be established, for breast cancer patients living on remote islands to visit institutions outside the island, and strive to reduce these difficulties.
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Mika Kamikokuryo, Naomi Funashima, Toshiko Nakayama, Mamiko Ueda, Kyok ...
Article type: Original Article
2025Volume 45 Pages
351-361
Published: 2025
Released on J-STAGE: July 25, 2025
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Purpose: Development of a “Self-Diagnosis Scale of Medical Accident Prevention Competency for ICU Nurses” with the aim of ensuring patient safety.
Methods: Identifying ICU nurses’ medical accident prevention behavior through qualitative research, development and scaling of 29 items based on the results of qualitative research, selection of questionnaire items using item response theory, and nationwide mail survey. The scale items were collected individually by anonymous mail.
Results: A total of 907 questionnaires were distributed and 304 valid datasets were analyzed. 15 items were selected using IRT, and a final version scale was produced therefrom. The information content of the scale was more than 9.24, the Cronbach’s alpha was .91, and the contribution to the first component by principal component analysis was 44.02%. Four hypotheses were supported by the known-group technique. The correlation coefficient using the retest method was .50, and the results of the confirmatory factor analysis were CFI = 0.88 and RMSEA = 0.09.
Conclusion: Although in terms of validity, the structural aspect of this scale remains an issue, it contains evidence from multiple facets and can be utilized as a measurement tool.
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Masayoshi Harada, Megumi Nagoshi, Sakae Mikane
Article type: Original Article
2025Volume 45 Pages
362-372
Published: 2025
Released on J-STAGE: July 25, 2025
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Purpose: This study aimed to elucidate the process by which young adult cancer survivors seek information that helps them in managing their daily lives following their diagnosis.
Method: Nineteen cancer survivors participated in semi-structured interviews, which were subsequently analyzed using M-GTA.
Results: Cancer survivors “obtain information on living with cancer from those who have experienced it and then share it themselves in order to connect with their peers.” They “look for ways to organize their lives by overcoming physical and mental pain and financial problems.” Furthermore, they “continue to seek information on living a life that is in line with their life cycle while living with cancer.” They encounter challenges when interacting with their children and parents and attempt to resolve issues through trial and error. Nevertheless, they also endeavor to prevent their children from experiencing hardships in the event of an emergency. Cancer survivors possess their own perspectives when it comes to gathering information.
Conclusion: It was evident that cancer survivors are actively pursuing ways to mitigate the pain associated with the disease, maintain social connections, and coexist with cancer while thinking about their families.
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Hiroyuki Shingu, Hiroaki Ambo, Shin Takaya
Article type: Material
2025Volume 45 Pages
81-89
Published: 2025
Released on J-STAGE: May 20, 2025
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Supplementary material
Purpose: In this study, we aimed to examine the relationship between work engagement and subscales of structural empowerment among non-managerial nurses, by years of experience.
Method: A questionnaire survey was conducted on work engagement and structural empowerment among 1,053 nurses working at 12 hospitals in Prefecture A and ordinance-designated city B in the Tohoku region of Japan. A hierarchical multiple regression analysis was conducted on the non-managerial nurses.
Results: The study included 397 non-managerial nurses. Among the subscales of structural empowerment, “Information” and “Support” were significantly related to work engagement among nurses with less than three years of experience, “Opportunity” was significantly related to work engagement among nurses with four to nine years of experience, and “Resources” and “Informal Power” were significantly related to work engagement among nurses with more than ten years of experience.
Discussion: The subscales of structural empowerment that contribute to improving the work engagement of non-managerial nurses differ depending on the number of years of experience. Therefore, measures tailored to the number of years of experience are required.
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Sayumi Tokushima, Miwako Terada, Yoshiko Miyamoto
Article type: Material
2025Volume 45 Pages
90-98
Published: 2025
Released on J-STAGE: May 23, 2025
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Aim: This study aims to clarify the impact of Team-Based Healthcare Education on nursing students’ learning (e.g., collaborative skills and understanding of professional roles) by comparing the online format and interdisciplinary group work format. Text mining was conducted to analyze student reports from different academic years, focusing on differences in learning outcomes due to educational methods.
Methods: Text mining was used to compare student reports from different academic years, analyzing differences in learning outcomes based on educational methods.
Results: Consent was obtained from 60 students for the online format and 44 students for the interdisciplinary group work format. In the online format, terms such as “medical” and “patient” were frequently used, while in the interdisciplinary group work format, collaboration-related terms like, “team” and “professionals” were more common. Differences in the co-occurrence and frequency of terms were observed between the two formats.
Conclusion: The interdisciplinary group work format was suggested to be beneficial for first-year students, as it provided opportunities to practically experience and deepen their foundational learning.
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Takahiko Maeda, Yuka Takuwa
Article type: Material
2025Volume 45 Pages
227-235
Published: 2025
Released on J-STAGE: June 27, 2025
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Objective: The objective of this study is to elucidate the feeling of difficulty perceived by nurses in caring for children in ICUs.
Methodology: Semi-structured interviews were conducted with 10 nurses recruited as participants in the study who worked in ICUs and had no previous nursing experience with children outside ICUs, and the results analyzed qualitatively applying the inductive approach.
Results: The following feelings of difficulty were identified: [Difficulty in communicating verbally with pediatric patients], [Difficulty with nursing techniques unique to pediatric patients], [There is a susceptibility to physical deteriorate compared to adult patients], [Difficulty in immediately switching perspective from adult patients to pediatric patients], [Care and an environment that keeps pediatric patients calm is not provided], [There are difficulties in supporting parents’ emotional needs] and [There are difficulties in working with pediatricians].
Conclusion: To address these feelings of difficulty, it is beneficial to provide ICU nurses with a certain period of training in pediatric wards and to assign experienced pediatric nurses to ICUs. Additionally, the study indicates that interprofessional collaboration with liaison nurses and clinical psychologists has the potential to enhance support for families of critically ill patients.
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Yuta Himeno, Hiromi Fukuda, Akihiro Araki, Akiko Yano
Article type: Material
2025Volume 45 Pages
278-285
Published: 2025
Released on J-STAGE: July 17, 2025
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Objective: This study aimed to evaluation of an education on decision-making support using the Japanese version of the OOVL.
Methods: The study targeted 80 second-year students enrolled in the Faculty of Nursing at University A. The evaluation of the education was investigated and analyzed by using original questionnaires to assess the preparation of the human environment necessary for decision-making support, support for decision-making processes, and support for decision expression, both before and after the classes on decision-making support. The data were analyzed using Wilcoxon signed rank test with EZR ver. 1.61.
Results: The analysis targeted 76 students who provided responses both before and after the class. Comparisons between pre- and post-class results showed a significant increase in scores after the class for four items related to the preparation of the human environment, seven items related to support for decision-making processes, and two items related to support for decision expression.
Conclusion: The results suggest that the Japanese version of the OOVL can be utilized as a tool to teach decision-making support in basic nursing education programs.
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Hidekazu Hishinuma, Takafumi Noguchi, Taku Kaneko, Tatsuya Saitou, Ken ...
Article type: Material
2025Volume 45 Pages
319-326
Published: 2025
Released on J-STAGE: July 23, 2025
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Objective: To clarify the difference in on-scene time (OST) by doctor helicopter boarding groups, including on the job training (OJT) for flight nurses.
Methods: We analyzed 6,957 individuals dispatched from 2010 to 2021 from the Tochigi prefecture doctor-helicopter database. Data regarding emergency medical services were compared across three groups of boarding staff: Group A (flight doctor, flight nurse, and OJT nurse), Group B (flight doctor and flight nurse), and Group C (two flight doctors and a flight nurse). One-way analysis of variance followed by post-hoc tests were performed to determine OST among the three groups.
Results: Mean OSTs (mean ± standard deviation) were 18.5 ± 8.0 minutes for Group A, 19.3 ± 10.3 minutes for Group B, and 16.9 ± 8.0 minutes for Group C, revealing significant differences among the three groups (p < 0.001). The OSTs for group A and B were longer than for group C, which had two flight doctors on board. No difference was found between groups A and B.
Conclusion: The on-board system, including OJT for flight nurses, suggests that education and practice can be carried out simultaneously without extending the OST.
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Yumiko Saito, Rie Wakimizu, Noriko Ozawa, Saori Saito
Article type: Material
2025Volume 45 Pages
338-350
Published: 2025
Released on J-STAGE: July 25, 2025
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Objective: This study aimed to develop a nursing education program that promotes positive attitudes toward and acquisition of knowledge and skills regarding end-of-life family support in neonatal intensive care units (NICUs), and to evaluate their satisfaction with the program.
Methods: The Analysis, Design, Development, Implementation, and Evaluation model of instructional design was employed to develop the program, which comprised 1.5 hours of on-demand e-learning video viewing and 3 hours of online group training. The participants were nurses who had completed Clinical Ladder Level II or higher programs working in NICUs or Growing Care Units (GCUs), having experience in end-of-life care in NICU. After completion of the program, participants evaluated it by responding to 12 survey items related to satisfaction with the educational program. Their responses were rated on a 7-point Likert scale. In addition, their opinions were obtained through free-text responses.
Results: The program included 52 NICU/GCU nurses. Between 80% and 90% of participants answered “agree” or “very much agree” on all items related to their satisfaction with the program. In their free response evaluations, they mentioned “deepening of knowledge” and “learning from other facilities and role-play.” This in turn led to “reflection and clarification of own care,” “willingness to use in practice and confidence,” and “clarification of future issues.”
Conclusions: The participants appeared highly satisfied with the program, confirming that the structure and content were generally appropriate and feasible. This program made it easy for nurses across facilities to participate, and the content was satisfying, suggesting that the program’s effectiveness in nursing practice is potentially recognizable.
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